Smoking and scuba diving. Can it be said that such a combination is a risk factor caisson disease? It is well known to most divers that drinking alcohol before diving can lead to dehydration, which in turn increases the risk of developing decompression sickness (DMS), also known as 'caisson' disease. From the very beginning, everyone who learns scuba diving is taught to avoid alcohol on the day of the dive, and even advises to refrain during the entire diving vacation. In economically developed countries, tour operators do not even offer alcohol to people who have registered as divers. At least until the diving is over. But what about tobacco?
Smoking seems to be a much less taboo for divers. I have observed many experienced divers smoking a cigarette just before the dive, in between dives, or immediately after a series of dives. Most smokers are likely to be familiar with the health problems caused by tobacco use, but choose to smoke despite all the known risks. However, it seems that smoking divers do not know how this activity affects DKS.
Does smoking increase the risk of caesarean section?
There is very little information on tobacco use in the medical literature related to scuba diving and it can provide only a small amount of knowledge about the effects of smoking on the risk of developing DKS. There is reason to believe that smoking-related illnesses such as emphysema, atherosclerosis, vasoconstriction and cholesterol deposits are prerequisites for severe swimming-related injuries such as arterial gas embolism or decompression sickness. A smoking diver may also be unaware of any of the above conditions. When we search for information on the web with the most popular search engines, Google and Yahoo, we find only a few articles that speak out against smoking combined with scuba diving for the reasons mentioned above. To date, there has been no in-depth study of the regularities of smoking and DKS.
Study "Diving and smoking"
The information gathered by DAN on accidents involving scuba divers also includes detailed information on the nature of the symptoms and whether the victim is a smoker. In the period from 1989 to 1999, more than 4,000 cases of DKS were registered. The information was passed on to scientists from Duke University (North Carolina, USA), where, in collaboration with DAN, an analysis of the information was performed. The findings of the study were published in the December 2003 issue of the journal Aviation, Space and Environmental Medicine. They say that, regardless of other factors, smokers have more severe DKS symptoms than non-smokers.
DKS includes a number of symptoms of varying severity, from itchy skin, joint pain to convulsions, loss of consciousness and death. Research entitled “Tobacco Smoking and the Severity of Decompression Sickness: A Retrospective Study of Holiday Divers” states that passionate smokers (15 or more pack years [one pack year means a smoker consumes one pack of cigarettes a day for a year]) tend to get more severe DKS. symptoms compared to less active smokers, who in turn have more severe symptoms compared to non-smoking divers.
Passionate smokers feel the difference
When passionate smokers were compared with non-smokers, it was found that smokers who developed DKS were twice as likely to experience more severe symptoms than mild ones. Approximately 371 passionate smokers with severe symptoms had severe symptoms, compared with only 241 non-smokers in similar conditions. Around 20% victims of non-smokers had only mild DKS symptoms, compared to smokers 14% (note, other smokers had more severe symptoms).
However, this study does not prove that smoking is the cause of DKS. However, it clearly showed that if DKS symptoms appear, then the smoking diver's severity tends to increase. The possible cause is a narrowing of the blood vessels in the lungs caused by smoking.
Are smoking associated with other risks?
When researching possible risk factors for DKS, scientists mostly use static methods, which may also mean that smoking influences the factors that secondarily affect the course of the disease. Studies are needed to confirm that smokers are at higher risk for DKS. It is necessary to know the overall percentage between smoking and non-smoking divers and the proportion who have suffered from DKS, but a comprehensive study is currently lacking baseline data.
Smokers must be prepared to bear the risk of harm to general health caused by tobacco consumption. Smokers may think that cancer, lung disease and heart disease are so far away that it will be possible to give up cigarettes before they start. In relation to scuba diving, the knowledge that smoking may be associated with more severe DKS symptoms is already a valid reason to give up another cigarette.
Original translation from the magazine "Octopus" Aug.-Sept. 2008 in Russian.
Text author D. med. David Buch.
The material is published by DAN Europe.
Translated into Russian by Anton Cherkasov
